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TomS
USA
32 Posts |
 Posted - 01/14/2004 : 11:42:54
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This is a little quirkey, but here is situation.
1998 Wind/Hail Storm blew 1/2 roof off and damaged interior. Big building,i.e., hospital.
Carrier paid for 1/2 roof, and interior damages withheld dep. and paid recoverable when repairs were made according to Adjusters and Agreed cost of repairs contractor.Arguments were made to replace entire roof, to no avail.
Now building is being placed on market to be purchased, and inspector found--guess what? yep, mold,and other damages that were apparently "hidden" or were not included or whatever.
Question--Can this claim be reopened. (no proof was signed)
Does the insured have either a old claim or should they file a new one or what.
What type of coverage under "most" policies would apply, if any?
Again, this is for a friends information, not handling either as I.A., or P.A. you know the drill, "what should or could I do about this"?
your bright ideas and mind and of course, the years of studying the policies, etc would be greatly appreciated.
If the guy can't get coverage, he is in a bind on selling property,etc.
thanks for all the awaited input.
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CCarr
Canada
1200 Posts |
Posted - 01/14/2004 : 12:33:23
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Tom, the policy in force for its term during the period for the 1998 loss, is not going to respond to any "loss", "discovered" or reported 5 or 6 years later.
However, one would have to consider the specific commercial wording in force at the time of "discovery" or any claim being reported, i.e. now, before I would want to venture a further thought.
If the risk is a hospital, are there not environmental screening procedures performed annually to monitor for microbal growth within the structure? That type of thing and other investigative aspects, in addition to the specific wording; should be reviewed. |
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catmanager
USA
102 Posts |
Posted - 01/14/2004 : 14:58:06
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You are going to need to provide policy form and endorsement information first of all. (Current policy)
Loss needs to be reinvestigated, just because there is a prior storm claim does not mean that current mold is related...
Insurance companies do not make repairs, contractors do. Mold needs moisture to grow, so was roof improperly repaired? Way too many variables to make armchair adjustments.....
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Edited by - catmanager on 01/14/2004 15:05:58 |
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TomS
USA
32 Posts |
Posted - 01/14/2004 : 19:53:22
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thanks guys, I appreciate the input. I am afraid as all have quoted, i did not have enough information to get good opinions. I am doing more research and at this time, I am looking to the "causation" and source of moisture, etc. My feeling is that the roof "should" have been replaced completly and at the time they got a quick adjustment and did not realize any future implications as in microbal growth and such.
I do appreciate the input and phone calls.
That is, after all, one of the purposes of this board. |
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KileAnderson
USA
875 Posts |
Posted - 01/14/2004 : 20:34:37
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| Tom, what kind of roof is it? If there were no leaks and the unreplaced portionn of the roof was not damaged how did the moisture get into the structure? |
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TomS
USA
32 Posts |
Posted - 01/15/2004 : 07:07:04
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Roof was a modified 4 ply. At present, I believe the water entered through or around the "tie" in where they overlapped and the edges around or near the flashing.
Quite frankly, I am questioning myself with everything now, I can't get a picture of where they want to go. So I am gonna do some more in depth investigation O:)) to see exactly what we have and re-post with more information for you guys to decipher for me.
but thanks for the interest!!! I keep saying these forums are really what this board is all about, and that is providing a place the adjuster can go and get "good" and factual answers.
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Tom Toll
USA
154 Posts |
Posted - 01/15/2004 : 08:00:30
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| Be sure and determine what deck the building has, steel, concrete, ISO,? How far back on the deck did the roofer peel back the plies from the remaining deck. Did he use the same deck material, if it was ISO. Did the peel back in layers or a straight cut. Was a moisture check pulled on the remaing roof? A flat built up roof can have a successful repair, but there are certain criteria that must be met for it to be a successful repair. Does the roof have a parapet or edge flashing? It doesn't make any difference whether a Proof of Loss was signed or not. If hidden damage was present and not determined, then the file can be and should be re-opened. I suspect the smart thing to do would be to get an engineer with a brain out there to take a look at it. |
Edited by - Tom Toll on 01/15/2004 08:07:31 |
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JimF
USA
1014 Posts |
Posted - 01/15/2004 : 10:19:19
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TomS, I think it behooves you to add to the equation here (based on your comments to me in an email), that while the carrier initially allowed replacement for one-half of the roof and paid based on the insured's roofer's estimate, that the insured in fact actually did the work of replacing half of the roof himself.
That is and should be an important factor in whether the previous carrier now owes for additional "unseen" damages that may or may not have been present when the roof was partially replaced earlier.
If I have my facts wrong, then perhaps adding this scenario to a discussion would benefit all of us in our understanding of how to handle a situation like this when the insured does make the repairs. |
Edited by - Tom Toll on 01/15/2004 10:53:06 |
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dhouse
USA
5 Posts |
Posted - 01/15/2004 : 21:26:58
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| When was the mold found? If the prior claim was paid in 98 and the repairs were done at that time, then this would most likely go to date of discovery as the date of loss. If the improper repairs were the cause of the problem, then you must look at it as a separate occurence, but, if there was hidden damage and it could be proven, then the statute of limitations would need to be reviewed. |
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ChuckDeaton
USA
373 Posts |
Posted - 01/16/2004 : 00:22:42
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I have never seen a policy that would cover mold caused by a roof leak, not even in Texas.
The only possible opening is for the insured to claim that the original investiation was inadequate and my guess would be that even the longer contractual statute of limitations has run.
My opinion is that this insured's luck has run out. Time to start grabbing at straws. |
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trader
USA
236 Posts |
Posted - 01/16/2004 : 22:44:38
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Fee bills, One shot claims. Now this the real world. What will you charge for $ 000. payment. Bail out with a CWP $125.00.
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TomS
USA
32 Posts |
Posted - 01/18/2004 : 07:17:52
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Hey Guys, thanks for the input, nice to have the pocket full of options
hey, ray, ain't got it near to billing yet, maybe 100.00 for cwop O:)) |
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Commercial Coverage Question
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